The future is indeed exciting. With new technologies and innovations, potential exists to truly help people around the world achieve optimum health status. But, there are concerns. For example, with more and more research, humans will find more ways to extend life. Is such an extension of life worth it? If innovations and technologies come along that, say, help people live as long as they want...what will that do to the current overpopulation problem? With new technologies, is there a way to ensure that this technologies will be distributed equitably amongst all citizens of the world?
As public health leaders, we must be aware of potential challenges and issues. It is only with this awareness that we can maximize the potential of the future.
Wednesday, May 7, 2008
Organizing and Mobilizing for Global Health
True change in the global health arena can only come about with the collaboration of several different partners and sectors. Relying solely on the public sector or national/international organizations cannot get the job done. In order to truly mobilize for global health, the public sector must partner with the private sector.
An interesting article on mobilizing for global health:
The GM-CDC partnership is likely to be a very powerful one. I believe that true partnerships such as these are crucial to the future of public health.
An interesting article on mobilizing for global health:
Corporate Social ResponsibilityNews  4.05.2006 ET
GM Fleet Mobilizes CDC's Global Health Force in Asia and AfricaGM Vehicles to Help Centers for Disease Control and Prevention Fight Public Health Threats (CSRwire) For more information please contact: Kate Ruddon or Shannon Easley , CDC Foundation Hilary Spittle , GM Communications For more CSR news and information from this organization: Corporate Social Responsibility Profile for General Motors Corporation More CSR headlines for news category Community Development Video, commentary & research for Community Development
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The GM-CDC partnership is likely to be a very powerful one. I believe that true partnerships such as these are crucial to the future of public health.
Thursday, April 24, 2008
Global Ethics
This session dealt with global ethics. When attempting to improve health in any way, such as, through clinical trials, governmental interventions, etc., there are a host of ethical issues that one must consider. Am I doing my job in the most fair way? Are minority groups being represented? Am I giving an unfair advantage to some groups over others?
One major health ethics issue, I believe, harkens back to what was discussed in session 11. When a government prioritizes diseases and bases those investments on these priorities, who is being left out? By doing this, we again get back to the very problem: the systematic isolation of the minority. Indeed, by prioritizing disease concerns, we will be leaving out that small percentage of people who have difficult, hard to treat, expensive diseases. Is this not an ethical issue that must be taken into account? How do we find a balanced solution?
I think ethics will also be a huge issue in terms of a potential avian influenza pandemic.
The WHO Ethics Report on preparing for an influenza pandemic poses several questions. If there is a shortage of drugs and vaccines, who will receive access to such vaccines, especially given potentially hectic conditions? What responsibility do countries have to each other? Do rich countries, such as the U.S. have a responsibility to help poorer countries in their fight against avian influenza? What is the role of healthcare workers and what are their obligations (given that they are at high risk for harm due to extensive interaction with sick patients).
I think it is highly important to develop a protocol and ask such questions on a regular basis. Having a sound and effective plan can eliminate a lot of dicey, ethical issues. It is extremely important that governments around the world prioritize such issues.
To apply a quote from Sicko (great presentation + video Charlyn and Funsho!), instead of spending so much money on killing people, such as through the Iraq War, why not spend that money helping people,say, by helping to prepare for a potential pandemic?
Here is the link to the article…its very interesting.
http://www.who.int/csr/resources/publications/WHO_CDS_EPR_GIP_2007_2c.pdf
One major health ethics issue, I believe, harkens back to what was discussed in session 11. When a government prioritizes diseases and bases those investments on these priorities, who is being left out? By doing this, we again get back to the very problem: the systematic isolation of the minority. Indeed, by prioritizing disease concerns, we will be leaving out that small percentage of people who have difficult, hard to treat, expensive diseases. Is this not an ethical issue that must be taken into account? How do we find a balanced solution?
I think ethics will also be a huge issue in terms of a potential avian influenza pandemic.
The WHO Ethics Report on preparing for an influenza pandemic poses several questions. If there is a shortage of drugs and vaccines, who will receive access to such vaccines, especially given potentially hectic conditions? What responsibility do countries have to each other? Do rich countries, such as the U.S. have a responsibility to help poorer countries in their fight against avian influenza? What is the role of healthcare workers and what are their obligations (given that they are at high risk for harm due to extensive interaction with sick patients).
I think it is highly important to develop a protocol and ask such questions on a regular basis. Having a sound and effective plan can eliminate a lot of dicey, ethical issues. It is extremely important that governments around the world prioritize such issues.
To apply a quote from Sicko (great presentation + video Charlyn and Funsho!), instead of spending so much money on killing people, such as through the Iraq War, why not spend that money helping people,say, by helping to prepare for a potential pandemic?
Here is the link to the article…its very interesting.
http://www.who.int/csr/resources/publications/WHO_CDS_EPR_GIP_2007_2c.pdf
Public Private Partnerships
This lecture discussed the role of public private partnerships in creating global change. We had Dr. Shahi buzz in from Nigeria, which was pretty cool =).
It is too difficult for one organization to do it alone. We cannot rely solely on the public sector to create global change in this world. In addition, the private sector often has the resources to truly speed global development and bring about positive changes. But, as anything, there are issues. These public private partnerships must be created very carefully and in such a way that both parties are excited about the process and outcome.
Here is an article that highlights some issues:
Layton: P3 projects not the answerNDP boss slams partnerships; N.S. minister fights backBy AMY SMITH Provincial ReporterThu. Apr 24 - 5:39 AM
Nova Scotians shouldn’t be fooled into thinking public-private partnerships will be good for the province, says federal NDP Leader Jack Layton.
Mr. Layton said Brampton, Ont., residents had a bad experience with a new hospital built through the P3 process.
"The funding wasn’t there for the number of beds that they were promised," Mr. Layton said after a speech Wednesday to the Service Employees International Union in Halifax.
"The result was horrific waiting times because their public hospital had been closed and replaced by this new profit-making facility, one-third of which was never allowed to really operate."
In February, The Canadian Press reported Ontario’s auditor general is conducting a value-for-money audit of the Brampton Civic Hospital, that province’s first P3 hospital.
Last month, the Tory government unveiled 10 projects as possible public-private partnerships — everything from a new or refurbished Victoria General hospital in Halifax to a new jail in northern Nova Scotia to twinning Highway 104 from Sutherlands River, Pictou County, to the Canso Causeway.
The province is paying a West Coast company, Partnerships British Columbia, $200,000 to determine which, if any, of the projects should be done through the P3 process.
Mr. Layton said problems occur when "the boardroom takes priority over the operating room."
"When you build these facilities with these private approaches, what we do is set up an obligation for a return on the investment to the shareholders, which ultimately can compromise the health care that the people in the community are looking for," he told reporters.
But Health Minister Chris d’Entremont said Nova Scotians have to be open to new ideas when it comes to making their tax dollars go further.
A recent report on Nova Scotia’s health-care system estimated the cost of replacing the entire VG site of the Queen Elizabeth II Health Sciences Centre at $500 million.
"I don’t have the cash flow to build a $500- million to $750-million building," he said. "So if we can find a partner in it and it can alleviate that kind of cash crunch, then it’s worth looking at."
Mr. d’Entremont stressed that patients are priority.
"It’s not about boardrooms. It’s not about departments. It’s not about doctors. It’s about patients."
The minister wasn’t familiar with the Brampton hospital but said he knows of a few in British Columbia that seem to be working well.
Murray Scott, minister of transportation and infrastructure renewal, said the province hasn’t made any decisions about any of the projects that were sent to Partnerships British Columbia for review.
He said Mr. Layton should concentrate his efforts on federal politics.
"We’ll decide what’s good for Nova Scotia or not," Mr. Scott said Wednesday.
He said it would be irresponsible for the MacDonald government not to at least look at the idea of P3 arrangements, given the fact Nova Scotia has an $8-billion infrastructure deficit.
Under a P3 agreement, a private company comes up with the money to build a project and the government signs a long-term lease and may end up owning the asset, whether it’s a school or a hospital, upon completion of the deal.
The former Liberal government in Nova Scotia worked out P3 agreements for construction of the Cobequid Pass toll highway and more than 30 schools.
Five years ago, the province lost an arbitration decision on who got to keep the revenue from cafeterias and pop machines in schools owned by Scotia Learning Centres.
That decision said the private consortium could keep 35 per cent of the profits and could also set fees for after-school rental of the buildings’ facilities.
( asmith@herald.ca)
As one can see, there is a fear that including the private sector in the building of hospitals will lead to an increased focus on making profits and other beaureaucratic (sp?) red tape issues.
I think the solution is to find a private partner who has a solid interest in social services and helping the community. It is highly important that the goals of the public and private entities be properly aligned. There are several private institutions out there that want to do good social work. It is just a matter of finding them. Once these entities are found and the partnership is established, there will be less of a focus on making a profit (on part of the private sector) and more of a focus on doing what is needed to really improve the health of the population.
It is too difficult for one organization to do it alone. We cannot rely solely on the public sector to create global change in this world. In addition, the private sector often has the resources to truly speed global development and bring about positive changes. But, as anything, there are issues. These public private partnerships must be created very carefully and in such a way that both parties are excited about the process and outcome.
Here is an article that highlights some issues:
Layton: P3 projects not the answerNDP boss slams partnerships; N.S. minister fights backBy AMY SMITH Provincial ReporterThu. Apr 24 - 5:39 AM
Nova Scotians shouldn’t be fooled into thinking public-private partnerships will be good for the province, says federal NDP Leader Jack Layton.
Mr. Layton said Brampton, Ont., residents had a bad experience with a new hospital built through the P3 process.
"The funding wasn’t there for the number of beds that they were promised," Mr. Layton said after a speech Wednesday to the Service Employees International Union in Halifax.
"The result was horrific waiting times because their public hospital had been closed and replaced by this new profit-making facility, one-third of which was never allowed to really operate."
In February, The Canadian Press reported Ontario’s auditor general is conducting a value-for-money audit of the Brampton Civic Hospital, that province’s first P3 hospital.
Last month, the Tory government unveiled 10 projects as possible public-private partnerships — everything from a new or refurbished Victoria General hospital in Halifax to a new jail in northern Nova Scotia to twinning Highway 104 from Sutherlands River, Pictou County, to the Canso Causeway.
The province is paying a West Coast company, Partnerships British Columbia, $200,000 to determine which, if any, of the projects should be done through the P3 process.
Mr. Layton said problems occur when "the boardroom takes priority over the operating room."
"When you build these facilities with these private approaches, what we do is set up an obligation for a return on the investment to the shareholders, which ultimately can compromise the health care that the people in the community are looking for," he told reporters.
But Health Minister Chris d’Entremont said Nova Scotians have to be open to new ideas when it comes to making their tax dollars go further.
A recent report on Nova Scotia’s health-care system estimated the cost of replacing the entire VG site of the Queen Elizabeth II Health Sciences Centre at $500 million.
"I don’t have the cash flow to build a $500- million to $750-million building," he said. "So if we can find a partner in it and it can alleviate that kind of cash crunch, then it’s worth looking at."
Mr. d’Entremont stressed that patients are priority.
"It’s not about boardrooms. It’s not about departments. It’s not about doctors. It’s about patients."
The minister wasn’t familiar with the Brampton hospital but said he knows of a few in British Columbia that seem to be working well.
Murray Scott, minister of transportation and infrastructure renewal, said the province hasn’t made any decisions about any of the projects that were sent to Partnerships British Columbia for review.
He said Mr. Layton should concentrate his efforts on federal politics.
"We’ll decide what’s good for Nova Scotia or not," Mr. Scott said Wednesday.
He said it would be irresponsible for the MacDonald government not to at least look at the idea of P3 arrangements, given the fact Nova Scotia has an $8-billion infrastructure deficit.
Under a P3 agreement, a private company comes up with the money to build a project and the government signs a long-term lease and may end up owning the asset, whether it’s a school or a hospital, upon completion of the deal.
The former Liberal government in Nova Scotia worked out P3 agreements for construction of the Cobequid Pass toll highway and more than 30 schools.
Five years ago, the province lost an arbitration decision on who got to keep the revenue from cafeterias and pop machines in schools owned by Scotia Learning Centres.
That decision said the private consortium could keep 35 per cent of the profits and could also set fees for after-school rental of the buildings’ facilities.
( asmith@herald.ca)
As one can see, there is a fear that including the private sector in the building of hospitals will lead to an increased focus on making profits and other beaureaucratic (sp?) red tape issues.
I think the solution is to find a private partner who has a solid interest in social services and helping the community. It is highly important that the goals of the public and private entities be properly aligned. There are several private institutions out there that want to do good social work. It is just a matter of finding them. Once these entities are found and the partnership is established, there will be less of a focus on making a profit (on part of the private sector) and more of a focus on doing what is needed to really improve the health of the population.
Healthcare Financing
Healthcare financing is a huge issue in terms of global health. Every year, money is being poured into ensuring the health of individuals. Yet, where is this money going? Is it being spent wisely?
There are two issues. I will try and tackle them both in this post.
Issue 1: Countries, such as the U.S., spend a ridiculous amount of money on healthcare. I believe the latest statistic is that healthcare is 16% of the GDP. Yet, the health of our citizens is actually not very good. In fact, there are 47 million people in the U.S. without healthcare. This is scary, because healthcare costs are continuing to rise. Dr. Shahi even mentioned that a large percentage of bankruptcy’s filed in the U.S. are caused by the expense of treating health conditions.
How is this possible in a country that spends SO much money on healthcare? A lot of people say that the very health system is not sound. A system of health insurance jacks up the price of healthcare while simultaneously making it hard for people to access necessary health services. It was mentioned in class that a health savings account may be a better solution. I will get back to this later.
Issue 2: Countries, such as Burundi, spend very little on healthcare, due to lack of resources. I believe Burundi spends something like $2 on healthcare per citizen. How can countries such as Burundi, then, even ensure the health of their citizens?
I gave a presentation in class (along with my colleague, Mark Krel), that I believe partially addresses issue 2. There is a need to prioritize healthcare needs and invest accordingly. There are a number of interventions that can be delivered that are effective but also give the most bang for the buck (and are often not too expensive). For example, delivering basic childhood vaccines is very cheap, effective, and can drastically reduce a number of long term health complications. Investing in such an intervention (such as a country-wide vaccination program) can be a very effective solution.
It is of utmost importance that governments of developing countries take disease prioritization as a top priority. They must do everything they can to invest wisely and make smart choices. This can be difficult. Many cost effective health interventions rely heavily on sound governmental policy. For example, one cost effective intervention proposed was a tobacco tax. Taxing tobacco will likely discourage people to smoke and thus reduce many long term health effects. Yet, many governments have been opposed to such a measure.
Now, back to issue 1: The debate between health insurance and a health savings account. Here is my issues with a health savings account. Suppose you save a certain amount of money for your healthcare needs. Then, you get diagnosed with a rare, expensive disorder, such as leukemia. If you count the treatment, plus hospital stays, plus ancillary care, you are talking about a pretty expensive disease to treat (some say around $400,000). What if you haven’t saved enough money? Thus, I still believe it is impossible to rely solely on a health savings account.
Of course health insurance has its holes as well (as we all know too well). Insurance companies want to make a profit, exclude high risk customers, deny treatment, etc.
So, what is the solution? I believe, in this case, the government must step in and actively control prices. Right now, esp. in the U.S., the private sector has way too much control on healthcare costs.
Of course, I can’t really say whether I have any specific ideas on how costs should be countered by the government…so please feel free to leave comments!!
There are two issues. I will try and tackle them both in this post.
Issue 1: Countries, such as the U.S., spend a ridiculous amount of money on healthcare. I believe the latest statistic is that healthcare is 16% of the GDP. Yet, the health of our citizens is actually not very good. In fact, there are 47 million people in the U.S. without healthcare. This is scary, because healthcare costs are continuing to rise. Dr. Shahi even mentioned that a large percentage of bankruptcy’s filed in the U.S. are caused by the expense of treating health conditions.
How is this possible in a country that spends SO much money on healthcare? A lot of people say that the very health system is not sound. A system of health insurance jacks up the price of healthcare while simultaneously making it hard for people to access necessary health services. It was mentioned in class that a health savings account may be a better solution. I will get back to this later.
Issue 2: Countries, such as Burundi, spend very little on healthcare, due to lack of resources. I believe Burundi spends something like $2 on healthcare per citizen. How can countries such as Burundi, then, even ensure the health of their citizens?
I gave a presentation in class (along with my colleague, Mark Krel), that I believe partially addresses issue 2. There is a need to prioritize healthcare needs and invest accordingly. There are a number of interventions that can be delivered that are effective but also give the most bang for the buck (and are often not too expensive). For example, delivering basic childhood vaccines is very cheap, effective, and can drastically reduce a number of long term health complications. Investing in such an intervention (such as a country-wide vaccination program) can be a very effective solution.
It is of utmost importance that governments of developing countries take disease prioritization as a top priority. They must do everything they can to invest wisely and make smart choices. This can be difficult. Many cost effective health interventions rely heavily on sound governmental policy. For example, one cost effective intervention proposed was a tobacco tax. Taxing tobacco will likely discourage people to smoke and thus reduce many long term health effects. Yet, many governments have been opposed to such a measure.
Now, back to issue 1: The debate between health insurance and a health savings account. Here is my issues with a health savings account. Suppose you save a certain amount of money for your healthcare needs. Then, you get diagnosed with a rare, expensive disorder, such as leukemia. If you count the treatment, plus hospital stays, plus ancillary care, you are talking about a pretty expensive disease to treat (some say around $400,000). What if you haven’t saved enough money? Thus, I still believe it is impossible to rely solely on a health savings account.
Of course health insurance has its holes as well (as we all know too well). Insurance companies want to make a profit, exclude high risk customers, deny treatment, etc.
So, what is the solution? I believe, in this case, the government must step in and actively control prices. Right now, esp. in the U.S., the private sector has way too much control on healthcare costs.
Of course, I can’t really say whether I have any specific ideas on how costs should be countered by the government…so please feel free to leave comments!!
Global Surveillance Capabilities:
This session talked about the different monitoring and surveillance capabilities for natural disasters, etc.
We went over the different disasters that our world has faced during this century as well as potential solutions to such disasters.
The interesting thing is this: In many of these situations, it seems like the response to such disasters in some ways caused even more harm than the disasters themselves!
For example, take Hurricane Katrina: Yes, the hurricane itself devastated the city of New Orleans. The government response, however, seemed to make it worse! First of all, people were not properly evacuated. Secondly, those who were evacuated often suffered from extreme hunger and thirst due to lack of food/water supplies (which should have properly been distributed by the government).
To further this criticism, many government officials, including those from FEMA, had promised to provide transportation for all citizens who needed to evacuate within 48 hours. Yet, many people were still forced to find their own transportation.
My favorite government excuse is this: Many people criticized the government, saying that the emergency relief response was too slow. One of the things that the U.S. Congress said in response was that there weren’t enough National Guard members in the New Orleans area due to being on active duty in Iraq. They were on duty in Iraq! It is ironic to me that these troops were in Iraq fighting an utterly useless war while there was a major hurricane going on in the U.S. and thus a major need for them to be on U.S. soil.
So my question or dilemma is this. We can say that we are creating fancy detection technologies. We can advertise the need for good epidemiology and surveillance systems. Indeed, this class lecture was great in identifying promising new technologies in the future. Yet, this seems completely useless without the government having the political will and compassion to address such situations. The U.S. is one of the richest countries in the world and has all the tools available to ensure a safe, smooth response to any disaster that occurs on this soil. Yet, laziness on part of the government made the situation with Katrina so much worse.
A key part of developing sound surveillance and monitoring systems to detect potential disasters is encouraging governments to prioritize such a need.
Basically, in the case of the U.S., we need to stop spending so much money on a useless war and invest the money spent on the Iraq war in protecting our citizens. Without this move, I fear we will face another Hurricane Katrina type disaster very soon.
We went over the different disasters that our world has faced during this century as well as potential solutions to such disasters.
The interesting thing is this: In many of these situations, it seems like the response to such disasters in some ways caused even more harm than the disasters themselves!
For example, take Hurricane Katrina: Yes, the hurricane itself devastated the city of New Orleans. The government response, however, seemed to make it worse! First of all, people were not properly evacuated. Secondly, those who were evacuated often suffered from extreme hunger and thirst due to lack of food/water supplies (which should have properly been distributed by the government).
To further this criticism, many government officials, including those from FEMA, had promised to provide transportation for all citizens who needed to evacuate within 48 hours. Yet, many people were still forced to find their own transportation.
My favorite government excuse is this: Many people criticized the government, saying that the emergency relief response was too slow. One of the things that the U.S. Congress said in response was that there weren’t enough National Guard members in the New Orleans area due to being on active duty in Iraq. They were on duty in Iraq! It is ironic to me that these troops were in Iraq fighting an utterly useless war while there was a major hurricane going on in the U.S. and thus a major need for them to be on U.S. soil.
So my question or dilemma is this. We can say that we are creating fancy detection technologies. We can advertise the need for good epidemiology and surveillance systems. Indeed, this class lecture was great in identifying promising new technologies in the future. Yet, this seems completely useless without the government having the political will and compassion to address such situations. The U.S. is one of the richest countries in the world and has all the tools available to ensure a safe, smooth response to any disaster that occurs on this soil. Yet, laziness on part of the government made the situation with Katrina so much worse.
A key part of developing sound surveillance and monitoring systems to detect potential disasters is encouraging governments to prioritize such a need.
Basically, in the case of the U.S., we need to stop spending so much money on a useless war and invest the money spent on the Iraq war in protecting our citizens. Without this move, I fear we will face another Hurricane Katrina type disaster very soon.
Saturday, March 22, 2008
Infocomm and Medical Devices
Imagine this: You walk into a doctors office, a doctor you have never seen before. You begin to tell your doctor about your health history. All of a sudden he/she stops you, turns to the computer, presses some buttoms and Voila! Your whole health history is right there, on the screen. Every lab test, every infection, allergy, every MRI done...it is all there.
Can you imagine the potential benefits of this? Drastically reduced medical errors, amount of time saved, not having to call some obscure office to locate the patients' medical record (which must be processed and then will be sent over).
Such a system is becoming a reality now. A system where all medical facilities all over the country, heck, even all over the world, are linked. Every patients medical history, stored in a neat little folder on the computer, that can be accessed anywhere, at any time, by any physician, with just a press of a button.
Health IT is indeed promising. Yet, getting these systems to "talk" has been a bit difficult. With increasing competition from different IT companies, it is difficult to implement one single system throughout an entire network of healthcare providers. Yet, despite these challenges, it is important to pursue such a system, as the benefits are great.
Telemedicine is also another promising venture. Being able to talk to a doctor through the computer, instead of having to wait in an office, is very promising. Of course, this system does not offer the benefits of actually being able to see the patient in person, but can be used for follow-up assignments and the like.
But how to implement such a system for communities that do not use the computer frequently (such as the old and the poor)? An idea brought up in class was to educate community leaders on how to use the computer and webcam. These leaders can then spread the knowledge of this innovation to everyone in the community.
Indeed, we live in exciting times. It is up to us to harness the vast potential of technology to improve communities around the world.
Can you imagine the potential benefits of this? Drastically reduced medical errors, amount of time saved, not having to call some obscure office to locate the patients' medical record (which must be processed and then will be sent over).
Such a system is becoming a reality now. A system where all medical facilities all over the country, heck, even all over the world, are linked. Every patients medical history, stored in a neat little folder on the computer, that can be accessed anywhere, at any time, by any physician, with just a press of a button.
Health IT is indeed promising. Yet, getting these systems to "talk" has been a bit difficult. With increasing competition from different IT companies, it is difficult to implement one single system throughout an entire network of healthcare providers. Yet, despite these challenges, it is important to pursue such a system, as the benefits are great.
Telemedicine is also another promising venture. Being able to talk to a doctor through the computer, instead of having to wait in an office, is very promising. Of course, this system does not offer the benefits of actually being able to see the patient in person, but can be used for follow-up assignments and the like.
But how to implement such a system for communities that do not use the computer frequently (such as the old and the poor)? An idea brought up in class was to educate community leaders on how to use the computer and webcam. These leaders can then spread the knowledge of this innovation to everyone in the community.
Indeed, we live in exciting times. It is up to us to harness the vast potential of technology to improve communities around the world.
Technology and Innovation
It is obvious that technological innovations are being produced and created at a dazzling rate. These technologies abound and are drastically changing the way we live our lives. Yet, how do we get these technologies to the people who need them and how do we ensure proper integration?
The answer is biopartnering and public private partnerships. Increasingly, the fields of biology and business are being integrated to form what is called "biobusiness". The biological/scientific sector is in charge of creating the technologies while the business sector is important to market and deliver these technologies.
Yet, how do we deliver technology to those who are poor? The corporate sector is surely to be hesitant to deliver such technologies (they want to make a profit!). The solution is public private partnerships: The public sector, which is interested in the common good, partners with the private sector, which has the technology. There are difficulties, however, in establishing these partnerships. Intellectual propery rights must be respected. Navigating through the various legal issues in implementing these technologies, especially in developing regions, can be challenging.
The goal is to create integrated partnerships. When both the public and private sector have a vested interest in the success of the application of the technology, the endeavor will be more successful! To create such opportunities, it is important to research the types of alliances that are sustainable.
Lastly, it is important to monitor the implemenation of such technologies. What is the cost effectiveness? Is it economically viable for the country? Is it effective and producing results?
These alliances can ensure that everyone in the world has access to technology that can drastically improve their lives.
The answer is biopartnering and public private partnerships. Increasingly, the fields of biology and business are being integrated to form what is called "biobusiness". The biological/scientific sector is in charge of creating the technologies while the business sector is important to market and deliver these technologies.
Yet, how do we deliver technology to those who are poor? The corporate sector is surely to be hesitant to deliver such technologies (they want to make a profit!). The solution is public private partnerships: The public sector, which is interested in the common good, partners with the private sector, which has the technology. There are difficulties, however, in establishing these partnerships. Intellectual propery rights must be respected. Navigating through the various legal issues in implementing these technologies, especially in developing regions, can be challenging.
The goal is to create integrated partnerships. When both the public and private sector have a vested interest in the success of the application of the technology, the endeavor will be more successful! To create such opportunities, it is important to research the types of alliances that are sustainable.
Lastly, it is important to monitor the implemenation of such technologies. What is the cost effectiveness? Is it economically viable for the country? Is it effective and producing results?
These alliances can ensure that everyone in the world has access to technology that can drastically improve their lives.
Environment, Sustainability, and Global Health
We all know, of course, that our physical environment is changing. Global warming is slowly causing temperatures to creep up. Whole ecosystems are being destroyed. Increasingly, damage to the environment is leading to harmful health effects.
"Our ability to live is what is at stake" says Al Gore, in his award winning documentary, "An Inconvenient Truth". The Arctic is experiencing melting at an alarming rate. If the ice caps are gone, sea levels would rise dramatically, flooding places like Florida and Shanghai. Al Gore then goes on to make an extremely valid point. We, right now, struggle when there is 100,000 refugees. With rising sea levels, he says, there would be over 100 million! This would cause enormous, unthinkable pressure on the world. How could we sustain ourselves?
Unfortunately, species are being eliminated at a rate that is 100 times faster than what it would be without human influence. Whole areas that used to be lush are now dry, barren, and infertile. Unfortunately, many of these areas are in developing countries, such as Sub Saharan Africa.
What is the answer to this? How can we reconcile the needs of human populations while at the same time protecting the environments and other species? The answer is sustainable developments. Concepts such as the carrying capacity (the amount of individuals an area can sustain) and the ecological footprint (the amount and type of resources needed to sustain such an area) are important to recognize when carrying out such an endeavor.
To go about doing this, it is important to build the correct infrastructure and develop the right policies. Programs that empower women can directly have an impact on the environment. Once women are empowered, they will influence and care for their families. Once families feel secure, people will start having less children. Correcting the human population crisis is one way to improve the environment.
My question, and struggle is this. Yes, development is great. Yet, with increased development, I, unfortunately tend to see a trend of increased car use and construction. For example, with the IT boom in Bangalore, India, the number of cars on the road has increased dramatically. There are more homes being built and more buildings being constructed. These things can cause destruction of whole species and ecosystems, since buildings are being constructed on places that different animal species consider home. How can we reconcile human development while still protecting the environment? How can we live in harmony with nature and other creatures? Yes, things like good roads, etc. are great. Yet, the building of roads can often drive whole families of animals apart (especially if not done carefully). This is my struggle...
"Our ability to live is what is at stake" says Al Gore, in his award winning documentary, "An Inconvenient Truth". The Arctic is experiencing melting at an alarming rate. If the ice caps are gone, sea levels would rise dramatically, flooding places like Florida and Shanghai. Al Gore then goes on to make an extremely valid point. We, right now, struggle when there is 100,000 refugees. With rising sea levels, he says, there would be over 100 million! This would cause enormous, unthinkable pressure on the world. How could we sustain ourselves?
Unfortunately, species are being eliminated at a rate that is 100 times faster than what it would be without human influence. Whole areas that used to be lush are now dry, barren, and infertile. Unfortunately, many of these areas are in developing countries, such as Sub Saharan Africa.
What is the answer to this? How can we reconcile the needs of human populations while at the same time protecting the environments and other species? The answer is sustainable developments. Concepts such as the carrying capacity (the amount of individuals an area can sustain) and the ecological footprint (the amount and type of resources needed to sustain such an area) are important to recognize when carrying out such an endeavor.
To go about doing this, it is important to build the correct infrastructure and develop the right policies. Programs that empower women can directly have an impact on the environment. Once women are empowered, they will influence and care for their families. Once families feel secure, people will start having less children. Correcting the human population crisis is one way to improve the environment.
My question, and struggle is this. Yes, development is great. Yet, with increased development, I, unfortunately tend to see a trend of increased car use and construction. For example, with the IT boom in Bangalore, India, the number of cars on the road has increased dramatically. There are more homes being built and more buildings being constructed. These things can cause destruction of whole species and ecosystems, since buildings are being constructed on places that different animal species consider home. How can we reconcile human development while still protecting the environment? How can we live in harmony with nature and other creatures? Yes, things like good roads, etc. are great. Yet, the building of roads can often drive whole families of animals apart (especially if not done carefully). This is my struggle...
Mind, Body, and Health
The mind, has a powerful control over our behavior and health. According to the Buddha, all that we are are a result of what we have thought. Indeed, the mental health has a significant effect on our well being and in the etiology of several physical ailments, such as diabetes, heart disease, hypertension, and even cancer! Those who are depressed tend to consistently show higher rates of such diseases.
Mental health not only causes such diseases, but results in high numbers of suicides and agressive/violent events. Examining the case of the Virginia Tech shooter is a case in point. Thus, it is clear that mental health takes an extreme physical and emotional toll on our lives.
Mental health is so important to our well being and sense of vitality that the King of Bhutan has included the nations' mental health status as a measure for national success. He came up with the idea of GNH, or Gross National Happiness, which he felt was a better measure of the state of the country than something like GNP (Gross National Product). I found this concept very interesting. The United States currently has one of the highest GNPs in the world. Financially, the U.S., is, of course, quite stable (although we are going into a recession but thats besides the point!). Yet, would we, as a country, score very high on a GNH scale? I think not. Although several slides (such as ones shown in class) show the U.S. to be very "happy", I don't think we are. We see such high rates of mental disorders, stress, and unhappiness. People often work too hard, sleep too late, and can't spend enough time with their families. This is in stark contrast to the environment of a place like India (a country that I often visit, given that I have family there). Yes, India is ridiculously dirty. The electrical current will go off at random times of the day. Yet, people are HAPPY. Their minds are constantly busy. They are surrounded by their friends and family.
*Speaking of the mind being busy, I thought that Mark Krel/Dr. Shahi made a great/funny comment in class. They called mental disorders, such as depression, a product of "affluenza" (a pun on the word influenza of course). Their claim is that many people who are in the upper echelons of society may just have too much time on their hands which can lead to an "idle mind is the devil's workshop" scenario. I thought it was a particularly interesting point.
The goal of public health/global health activists is to create situations where people can lead full, satisfying lives. This will, indeed, bring down levels of preventable diseases and violent events.
My question to end this post is this: What is the most sustainable way to improve mental health in developing nations? Many people living in affluent countries often resort to pills to alleviate their mental status, such as anti-depressants and SSRI's. Is the delivery of these drugs a potential answer for developing countries? The culture of many countries that are considered "developing", such as India, still view mental illness as a taboo. How do we get the people in these countries to take up the cause of mental health?
Mental health not only causes such diseases, but results in high numbers of suicides and agressive/violent events. Examining the case of the Virginia Tech shooter is a case in point. Thus, it is clear that mental health takes an extreme physical and emotional toll on our lives.
Mental health is so important to our well being and sense of vitality that the King of Bhutan has included the nations' mental health status as a measure for national success. He came up with the idea of GNH, or Gross National Happiness, which he felt was a better measure of the state of the country than something like GNP (Gross National Product). I found this concept very interesting. The United States currently has one of the highest GNPs in the world. Financially, the U.S., is, of course, quite stable (although we are going into a recession but thats besides the point!). Yet, would we, as a country, score very high on a GNH scale? I think not. Although several slides (such as ones shown in class) show the U.S. to be very "happy", I don't think we are. We see such high rates of mental disorders, stress, and unhappiness. People often work too hard, sleep too late, and can't spend enough time with their families. This is in stark contrast to the environment of a place like India (a country that I often visit, given that I have family there). Yes, India is ridiculously dirty. The electrical current will go off at random times of the day. Yet, people are HAPPY. Their minds are constantly busy. They are surrounded by their friends and family.
*Speaking of the mind being busy, I thought that Mark Krel/Dr. Shahi made a great/funny comment in class. They called mental disorders, such as depression, a product of "affluenza" (a pun on the word influenza of course). Their claim is that many people who are in the upper echelons of society may just have too much time on their hands which can lead to an "idle mind is the devil's workshop" scenario. I thought it was a particularly interesting point.
The goal of public health/global health activists is to create situations where people can lead full, satisfying lives. This will, indeed, bring down levels of preventable diseases and violent events.
My question to end this post is this: What is the most sustainable way to improve mental health in developing nations? Many people living in affluent countries often resort to pills to alleviate their mental status, such as anti-depressants and SSRI's. Is the delivery of these drugs a potential answer for developing countries? The culture of many countries that are considered "developing", such as India, still view mental illness as a taboo. How do we get the people in these countries to take up the cause of mental health?
Monday, March 10, 2008
Session 5: Nutrition, Food Security, Health
Often times, when talking about nutrition, we do not bring in “the whole picture”. That is, we often say that people are undernourished because they cannot access food. The concept of food security, however, adds a dimension to this concept of nutrition. The concept of food security not only involves access, but distribution, production, and safety. Food may be accessible but may not be safe to eat. Or it may be that fertile land is available to produce such food, but that the agricultural sector does not have the proper tools to produce food. Without these things, individuals cannot be secure that safe healthy food is available to them.
Countries such as Africa are incredibly food insecure, for they are impacted not only in terms of access but, distribution, production, and safety. I gave a presentation on the delivery of technologies to resource poor farmers. Farmers in Africa do not have the tools available to make the most out of the land that is available to them. Making these technologies available to farmers can drastically increase the quantity of safe, healthy food that is available. Yet, the process of delivering these technologies is complicated, for one has to establish partnerships with the private companies that hold these technologies. In addition, the people using these technologies have to make sure that they are not infringing on the intellectual property of these companies.
Jocelyn gave an interesting presentation on obesity in the media. The article mentions that most media outlets portray obesity to be the result of poor nutrition and laziness. Yet, the media often neglects the role of the environment of the individual. For example, an individual may feel alienated in their surroundings, which could increase their feelings of depression, which can in turn lead to stress eating. This article advocates changing the environment to help alleviate the obesity epidemic.
Jocelyn’s presentation really got me thinking of the concept of food security. For example, living in a place where the majority of restaurants are of the fast food type can lead to food insecurity. Yes, this food is cheap and thus food is widely available to the individuals living in that area. Yet, this food is often unhealthy. Given that the food is of low quality, food security drastically decreases. Thus, most people do not think of the United States as a country that is ridden with issues of malnutrition and food insecurity. Yet, given the abundance of such unhealthy food available, I think food security is a big issue in this country.
Countries such as Africa are incredibly food insecure, for they are impacted not only in terms of access but, distribution, production, and safety. I gave a presentation on the delivery of technologies to resource poor farmers. Farmers in Africa do not have the tools available to make the most out of the land that is available to them. Making these technologies available to farmers can drastically increase the quantity of safe, healthy food that is available. Yet, the process of delivering these technologies is complicated, for one has to establish partnerships with the private companies that hold these technologies. In addition, the people using these technologies have to make sure that they are not infringing on the intellectual property of these companies.
Jocelyn gave an interesting presentation on obesity in the media. The article mentions that most media outlets portray obesity to be the result of poor nutrition and laziness. Yet, the media often neglects the role of the environment of the individual. For example, an individual may feel alienated in their surroundings, which could increase their feelings of depression, which can in turn lead to stress eating. This article advocates changing the environment to help alleviate the obesity epidemic.
Jocelyn’s presentation really got me thinking of the concept of food security. For example, living in a place where the majority of restaurants are of the fast food type can lead to food insecurity. Yes, this food is cheap and thus food is widely available to the individuals living in that area. Yet, this food is often unhealthy. Given that the food is of low quality, food security drastically decreases. Thus, most people do not think of the United States as a country that is ridden with issues of malnutrition and food insecurity. Yet, given the abundance of such unhealthy food available, I think food security is a big issue in this country.
Session 4: Changing Trends in Noncommunicable Diseases
Preventive Medicine. This is a “buzz phrase” that we are increasingly hearing in the news and other media outlets. Indeed, the world has seen a rise in noncommunicable, preventable diseases, such as diabetes and heart disease. Unfortunately, these diseases are often expensive to treat and cause significant morbidity and mortality.
Of course, many of these disease have a genetic component. Yet, it has recently been discovered that many of these diseases are preventable. For example, Dr. Shahi mentioned that when he was in medical school, contracting diabetes was something that was out of the individuals control. It is now known that exercise and diet can prevent as much as 80% of diabetes cases!
It is easy to think, however, that noncommunicable diseases are the burden of the rich and wealthy. As we learned from a wonderful presentation by Wilmin Lam, poor countries such as Africa, suffer from problems such as obesity and diabetes. In African culture (or at least in the study group about which Wilmin presented), many people believed that being large and overweight was a sign of health and thus was a marker for beauty.
I believe Wilmins presentation really is what made this class so interesting for me. We have heard, a thousand times, that countries such as the U.S. are suffering from an obesity/diabetes pandemic. Yet, other countries, such as Africa and South Asia, must not be neglected, as noncommunicable diseases can often significantly burden these countries as well.
Of course, many of these disease have a genetic component. Yet, it has recently been discovered that many of these diseases are preventable. For example, Dr. Shahi mentioned that when he was in medical school, contracting diabetes was something that was out of the individuals control. It is now known that exercise and diet can prevent as much as 80% of diabetes cases!
It is easy to think, however, that noncommunicable diseases are the burden of the rich and wealthy. As we learned from a wonderful presentation by Wilmin Lam, poor countries such as Africa, suffer from problems such as obesity and diabetes. In African culture (or at least in the study group about which Wilmin presented), many people believed that being large and overweight was a sign of health and thus was a marker for beauty.
I believe Wilmins presentation really is what made this class so interesting for me. We have heard, a thousand times, that countries such as the U.S. are suffering from an obesity/diabetes pandemic. Yet, other countries, such as Africa and South Asia, must not be neglected, as noncommunicable diseases can often significantly burden these countries as well.
Changing Trends in Communicable Diseases
During this session, Dr. Shahi presented a fascinating look at the different communicable diseases that afflict the world population. Unfortunately, such diseases disproportionately affect those countries that are poor and lack the resources to properly treat these disorders. In fact, most “rich” countries are suffering less from communicable diseases and more from noncommunicable, chronic diseases, such as diabetes and heart disease. Even when those who are well off contract communicable diseases, they die at a much lower rate than those who are poor.
To make things worse, many of the efforts to control communicable diseases in poor countries have focused on a select few diseases, such as HIV and Malaria. Unfortunately, there are other diseases that often occur that can cause severe damage but are often not the focus of prevention/treatment efforts. These include Chagas disease and Schistosomiasis.
We then went over epidemic, pandemics, and heard a wonderful presentation by Juleon regarding the history of communicable diseases.
My main question is, with the possibility of a pandemic of certain communicable diseases, such as SARS or Avian Flu, will poor countries disproportionately be affected? Will most of the funding and efforts go to eradicating such diseases in rich countries, while neglecting the poor countries? Since it is the rich countries that often provide such funding, I believe this to be very possible. How can we circumvent this situation? How can we make sure that everyone is protected from such threats?
To make things worse, many of the efforts to control communicable diseases in poor countries have focused on a select few diseases, such as HIV and Malaria. Unfortunately, there are other diseases that often occur that can cause severe damage but are often not the focus of prevention/treatment efforts. These include Chagas disease and Schistosomiasis.
We then went over epidemic, pandemics, and heard a wonderful presentation by Juleon regarding the history of communicable diseases.
My main question is, with the possibility of a pandemic of certain communicable diseases, such as SARS or Avian Flu, will poor countries disproportionately be affected? Will most of the funding and efforts go to eradicating such diseases in rich countries, while neglecting the poor countries? Since it is the rich countries that often provide such funding, I believe this to be very possible. How can we circumvent this situation? How can we make sure that everyone is protected from such threats?
Sunday, February 3, 2008
Globalization and Health
Dr. Shahi's lecture on globalization and health was very enlightening and raised several important issues. First of all, the lecture included a significant chunk of information on the urban-rural divide in healthcare. Urban populations are often a lot healthier. They experience lower death rates as well as a overall higher degree of health. This is largely due to infrastructure. Urban areas have a set infrastructure in place that better equips its inhabitants with basic necessities such as food, shelter, and clean water. This infrastructure is often absent in rural areas.
India provides a great example of this dichotomy. India (especially the southern city of Bangalore) is known for the enormous growth that it has experienced over the past decade or so. This growth is very evident in large cities such as Bangalore. Yet, when stepping into the rural areas, one gets a sense of how the distribution of resources heavily favors those in urban areas. People living in rural areas often live in flimsy huts and do not have access to clean water. Building a more solid infrastructure, as was suggested in class, is crucial.
The idea of infrastructure and development was also discussed in the context of birth and death rates. Development leads to empowerment in many ways. People have greater access to healthcare, better sanitation, and cleaner water. This directly leads to low death rates. Once people start feeling secure about their life expectancy and overall well being, they will start having fewer children. A change in birth rates thus often follows a change in death rates.
Interestingly, as Dr. Shahi mentions, much of the positive trends in death have been attributed to advanced medical technologies. Yet, it is development and strong infrastructure that deserve the most credit in these positive trends.
(This is a bit off topic): I was a bit confused about the difference between universal coverage and universal access to healthcare. Aren't these two notions inextricably intertwined? Universal access to healthcare does depend on factors such as language, ethinicity, SES, the distance that one lives from a medical facility, etc. I believe that insurance coverage is one HUGE factor in access to care. Indeed, many people often die or live very unhealthy lives because they do not have proper coverage. Thus, I can notice a slight distinction between the notion of universal coverage and access but are these two concepts really that different? Maybe there is something I am missing to the argument that Dr. Shahi posed in class. Hopefully someone will comment on this blog to clear up my confusion...
India provides a great example of this dichotomy. India (especially the southern city of Bangalore) is known for the enormous growth that it has experienced over the past decade or so. This growth is very evident in large cities such as Bangalore. Yet, when stepping into the rural areas, one gets a sense of how the distribution of resources heavily favors those in urban areas. People living in rural areas often live in flimsy huts and do not have access to clean water. Building a more solid infrastructure, as was suggested in class, is crucial.
The idea of infrastructure and development was also discussed in the context of birth and death rates. Development leads to empowerment in many ways. People have greater access to healthcare, better sanitation, and cleaner water. This directly leads to low death rates. Once people start feeling secure about their life expectancy and overall well being, they will start having fewer children. A change in birth rates thus often follows a change in death rates.
Interestingly, as Dr. Shahi mentions, much of the positive trends in death have been attributed to advanced medical technologies. Yet, it is development and strong infrastructure that deserve the most credit in these positive trends.
(This is a bit off topic): I was a bit confused about the difference between universal coverage and universal access to healthcare. Aren't these two notions inextricably intertwined? Universal access to healthcare does depend on factors such as language, ethinicity, SES, the distance that one lives from a medical facility, etc. I believe that insurance coverage is one HUGE factor in access to care. Indeed, many people often die or live very unhealthy lives because they do not have proper coverage. Thus, I can notice a slight distinction between the notion of universal coverage and access but are these two concepts really that different? Maybe there is something I am missing to the argument that Dr. Shahi posed in class. Hopefully someone will comment on this blog to clear up my confusion...
Sunday, January 27, 2008
The Grameen Bank
My first blog entry was kind of an introduction and didn't not directly relate to what was discussed in class. Here is another post on a subject that is very near and dear to my heart that Dr. Shahi discussed at length.
I have long been interested in the work of Dr. Yunus. I often wondered how exactly concepts of microfinance tie in with health and how I, as a student of the sciences and health, can be involved in a venture such as the Grameen Bank.
I am so excited that Dr. Shahi talked about the the work of Dr. Yunus and the Grameen Bank. From the lecture (information about which I obtained through a friend since I was not in class on Monday), I learned that the work of Dr. Yunus directly relates to global health!
I actually read a journal article recently that discussed the interconnections between microfinance and health outcomes.
The author laid out several implications of poor health on the success of an MFI (microfinance institution) and loan repayment. These include " delayed loan repayment, inability to repay loans, poor attendance at MFI meetings, decrease in client business performance, undermining MFI group solidarity". The author suggests that the full potential of microfinance can only be realized when the individuals are health and thus suggests the health education and promotion methods should be an integral part of microfinancial strategies.
Yet many MFI practicioners believe that "the financial viability of the microfinance services as a business has made practitioners very cautious about non financial add ons. They believe that add ons can only be a drag on the drive for sustainability".
To counter this idea, the author suggests several methods of maintaining or even increasing sustainability while offering health services. She suggests linking two independent organizations (one focused on microfinance and one on healthcare services delivery). These two independent organizations would operate at the same time and place and offer their services in a concurrent manner.
Another strategy would be to have a "generalist or multipurpose organzation offer both microfinance serves through one program while offering other sector services through a different program or staff of the same organization".
These are very exciting and promising strategies to align health and financial services. I hope to learn more about these interconnections in the future!
Link to the article:http://marriottschool.byu.edu/conferences/selfreliance/presentations/Microfinance%20_%20Health%20-%20Chandni%20Ohri.pdf
I have long been interested in the work of Dr. Yunus. I often wondered how exactly concepts of microfinance tie in with health and how I, as a student of the sciences and health, can be involved in a venture such as the Grameen Bank.
I am so excited that Dr. Shahi talked about the the work of Dr. Yunus and the Grameen Bank. From the lecture (information about which I obtained through a friend since I was not in class on Monday), I learned that the work of Dr. Yunus directly relates to global health!
I actually read a journal article recently that discussed the interconnections between microfinance and health outcomes.
The author laid out several implications of poor health on the success of an MFI (microfinance institution) and loan repayment. These include " delayed loan repayment, inability to repay loans, poor attendance at MFI meetings, decrease in client business performance, undermining MFI group solidarity". The author suggests that the full potential of microfinance can only be realized when the individuals are health and thus suggests the health education and promotion methods should be an integral part of microfinancial strategies.
Yet many MFI practicioners believe that "the financial viability of the microfinance services as a business has made practitioners very cautious about non financial add ons. They believe that add ons can only be a drag on the drive for sustainability".
To counter this idea, the author suggests several methods of maintaining or even increasing sustainability while offering health services. She suggests linking two independent organizations (one focused on microfinance and one on healthcare services delivery). These two independent organizations would operate at the same time and place and offer their services in a concurrent manner.
Another strategy would be to have a "generalist or multipurpose organzation offer both microfinance serves through one program while offering other sector services through a different program or staff of the same organization".
These are very exciting and promising strategies to align health and financial services. I hope to learn more about these interconnections in the future!
Link to the article:http://marriottschool.byu.edu/conferences/selfreliance/presentations/Microfinance%20_%20Health%20-%20Chandni%20Ohri.pdf
An Introduction: The System
Hi everyone! My name is Amitha Prasad. Welcome to my blog! I hope that you find this blog to be a source of insight into issues, both apparent and hidden, that affect the health of individuals and communities around the world.
First things first, here is a little about me: I graduated from Pomona College in May 2006, where I earned a B.A. in Neuroscience. I am in my last semester in the USC MPH program. I am in the Biostat/Epi track and have taken several classes on global health. My hope is to obtain an M.D., merge the skills I learned in this MPH program and medical school, and somehow contribute positively to society!
Now that that's out of the way, lets move on.
I had a very interesting encounter on Friday that I believe will make a great first blog entry. I had the wonderful opportunity to meet with Dr. Douglas Vanderbilt, a developmental-behavioral pediatrician, in order to discuss a potential practicum. I told him about my interest in global health and how I am planning to do international work this summer. He said he had gone on several "international missions" in his younger, college going, idealism enwrapped days. He then posed an interesting question to me. He said "Amitha, both you and I know so many people who go on these short trips. Indeed, the work that is done is wonderful, but can it really bring about lasting change?"
This question struck me.
You see, in college, I was constantly told about this need for change. Change the education system, change racial dynamics, etc, etc. But how to bring about this magical, enigmatic thing called "change"?
After several fruitful and heated conversations with my amazing colleagues and professors, I came to two conclusions:
1) Change is a long process
2) Lasting change can only be brought about by changes in "the system": the deep, strong framework through which society functions, thrives, and yes, falls. It is a set of values, traditions,, and attitudes that are deeply entrenched in the minds of people. Unfortunately, this system is so entrenched in our society that many times, we cannot even see it.
I think this concept applies strongly to global health. I believe that many global health problems arise from "the system". Traditions, gender differences, attitudes towards women, men, people of different ethnicities, homosexuals, etc, etc. all strongly contribute to diseases that we see in the international community. The woman in rural India who is malnourished may be taught to first serve food to her husband and then eat whatever is left over because to her and others, the husband is the equivalent to God. Black Africans in South Africa have overall poorer health than White Africans, perhaps due to racial attitudes. I can go on and on.
I believe that the medical missions that many people go on are very valuable. But I do not think that these missions are enough to bring about lasting change. But how can we, as future public health professionals, bring about this change?
This is something I have struggled with. I want to help the global community. But I also want to live the rest of my life in the comforts of my middle class, American lifestyle (as many of us do, probably). Yes I, like many others, will make time to go perhaps on yearly international trips. But besides this, what can we do, from our vantage point, to help change a system that has given rise to so many global health concerns?
I hope that this class equips us with deeper knowledge of systematic issues affecting global health and ways to change this system.
As a side note...I hope this blog entry was not offensive. I am not trying to take away from the amazing work that is done by people who go abroad and help out so many in need. And I am not saying that these trips have not created change. They have. I just believe that it is not enough. I think lasting change can be brought about by something deeper.
First things first, here is a little about me: I graduated from Pomona College in May 2006, where I earned a B.A. in Neuroscience. I am in my last semester in the USC MPH program. I am in the Biostat/Epi track and have taken several classes on global health. My hope is to obtain an M.D., merge the skills I learned in this MPH program and medical school, and somehow contribute positively to society!
Now that that's out of the way, lets move on.
I had a very interesting encounter on Friday that I believe will make a great first blog entry. I had the wonderful opportunity to meet with Dr. Douglas Vanderbilt, a developmental-behavioral pediatrician, in order to discuss a potential practicum. I told him about my interest in global health and how I am planning to do international work this summer. He said he had gone on several "international missions" in his younger, college going, idealism enwrapped days. He then posed an interesting question to me. He said "Amitha, both you and I know so many people who go on these short trips. Indeed, the work that is done is wonderful, but can it really bring about lasting change?"
This question struck me.
You see, in college, I was constantly told about this need for change. Change the education system, change racial dynamics, etc, etc. But how to bring about this magical, enigmatic thing called "change"?
After several fruitful and heated conversations with my amazing colleagues and professors, I came to two conclusions:
1) Change is a long process
2) Lasting change can only be brought about by changes in "the system": the deep, strong framework through which society functions, thrives, and yes, falls. It is a set of values, traditions,, and attitudes that are deeply entrenched in the minds of people. Unfortunately, this system is so entrenched in our society that many times, we cannot even see it.
I think this concept applies strongly to global health. I believe that many global health problems arise from "the system". Traditions, gender differences, attitudes towards women, men, people of different ethnicities, homosexuals, etc, etc. all strongly contribute to diseases that we see in the international community. The woman in rural India who is malnourished may be taught to first serve food to her husband and then eat whatever is left over because to her and others, the husband is the equivalent to God. Black Africans in South Africa have overall poorer health than White Africans, perhaps due to racial attitudes. I can go on and on.
I believe that the medical missions that many people go on are very valuable. But I do not think that these missions are enough to bring about lasting change. But how can we, as future public health professionals, bring about this change?
This is something I have struggled with. I want to help the global community. But I also want to live the rest of my life in the comforts of my middle class, American lifestyle (as many of us do, probably). Yes I, like many others, will make time to go perhaps on yearly international trips. But besides this, what can we do, from our vantage point, to help change a system that has given rise to so many global health concerns?
I hope that this class equips us with deeper knowledge of systematic issues affecting global health and ways to change this system.
As a side note...I hope this blog entry was not offensive. I am not trying to take away from the amazing work that is done by people who go abroad and help out so many in need. And I am not saying that these trips have not created change. They have. I just believe that it is not enough. I think lasting change can be brought about by something deeper.
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